Provider Demographics
NPI:1093428351
Name:LANGSTON, AUSTIN (PA-C)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:
Last Name:LANGSTON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8551 OAK VILLAGE BLVD
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-9554
Mailing Address - Country:US
Mailing Address - Phone:567-232-2160
Mailing Address - Fax:
Practice Address - Street 1:2441 OLD STRINGTOWN RD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-3922
Practice Address - Country:US
Practice Address - Phone:614-317-9990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.008656RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant